Keneba

MRC Keneba is a rural field station situated in the Kiang West region of The Gambia, about 2 hours by roadfrom MRC Fajara. It is located in the village of Keneba – the largest village in an area of predominantlysubsistence agriculture. The MRC has had a presence in the area for 60 years and enjoys an excellentrelationship with the local community. Most research activities of the NUT are done in Keneba.

The Keneba Clinic is a vital facility for data collection and study implementation as well as supporting thecore pact with the local population of ‘no survey without service’ that has been in place for the past 40years. The clinic provides an extensive, outpatient‐based service concentrating on maternal and childhealth provision and working closely with the local Gambian Government Divisional Health Team. Clinicsare run five days per week and a supplementary feeding centre for malnourished children is maintainedseven days per week, as well as an emergency out‐of‐hours service offering medical, midwifery and nursingcare. The clinic is heavily used as a research tool through the use of the Keneba Electronic MedicalRegistration System (KEMReS), which is currently being linked to the genetic databases of the localpopulation to facilitate ‘genes‐in‐action’ studies. The clinic also supports the local Karantaba Health Centreand the Maternal and Child Health trekking teams that deliver healthcare directly to the villages. Thisintensity of health care has resulted in impressive improvements in mortality rates but a high burden ofinfectious diseases and under‐nutrition remains. The field station has a strong record in training ourGambian and other West African staff from basic to post‐doctoral levels. Keneba hosts many overseasstudents and researchers, especially medical elective and MSc students from LSHTM.

The villages of Keneba, Manduar and Kantong‐Kunda have traditionally maintained the closest relationshipwith the field station and we have unique demographic and health databases spanning 65 years.Increasingly our studies and clinical service involve many other villages across West Kiang.

Keneba maintains moderately advanced laboratory facilities that are modified to be appropriate to thework in hand and tailored to assays that must be done on fresh samples. The Keneba biobank (see below) iscurrently a major user of bench space and facilities. Studies in the Iron, Infection and Anaemia sub‐themeare using Cat II facilities for cell culture in Keneba’s NIH‐funded work on Plasmodium falciparum growth iniron‐deficient erythrocytes and BMGF‐funded work involving ex vivo bacterial assays to assess the safety intrials of screen‐and‐treat iron supplementation. Following many years of underinvestment, leading tohealth and safety concerns and the labs and clinic being unfit for service, the Keneba labs and clinic areundergoing a major refurbishment to be completed in 2015. More advanced assays (usually immunological)are conducted in Fajara in collaboration with VI.

In addition to storing residual samples from on‐going and completed studies we are currently creating acomprehensive biobank of all consenting individuals across West Kiang. This collects DNA, physiologicalsamples, anthropometry and basic phenotypic data (e.g. blood pressure, haematology, etc.) and banks itusing a rigorous bar‐coded tracking system and data‐bases, all of which were designed in house. Data andsamples from 6000+ individuals have been already banked. In addition to diving much of our own research,it is our intention to ‘externalise’ the biobank to make it more readily available to external collaborators inorder to maximise the use of the samples in support of our ethics responsibilities.

In support of the Early Growth & Development; and Calcium, Vitamin D and Bone Health sub‐themes,Keneba maintains the Bakary Dibba Clinical Physiology Laboratories containing state‐of‐the‐art imaging andtest systems for assessing bone density, morphology and architecture, infant and adult body composition(DXA and PeaPod air displacement plethysmography) and foetal growth and thymic size (ultrasound). Anew DXA has recently been installed in Fajara in support of CDBH’s research into the impact of urbanmigration.